Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Colleen Chawla, Chief, San Mateo County Health
Jei Africa, Director, Behavioral Health and Recovery Services
Subject: Amendment to the Agreement with Psynergy Programs, Inc. for Residential Mental Health Services
RECOMMENDATION:
title
Adopt a resolution authorizing an amendment to the agreement with Psynergy Programs, Inc. for residential mental health services, increasing the amount by $279,000 to an amount not to exceed $5,809,122, with no change to the agreement term.
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BACKGROUND:
On June 25, 2024, this Board approved an agreement with Psynergy Programs, Inc. authorizing expenditures for residential care facilities serving mentally ill clients and providing residential care services for County adults. The term of the agreement is July 1, 2024, through June 30, 2027, in an amount not to exceed $5,530,122. Psynergy Programs, Inc. (Psynergy) provides a full range of mental health residential services, which include rehabilitative mental health services, psychiatric services, medication support, individual and group therapy, therapeutic programs with enhanced medical support for specific issues (e.g., diabetes), and a Modified Therapeutic Community. Psynergy’s programs emphasize independent living skills, nutrition, and exercise. Psynergy has facilities located in Santa Clara County, Monterey County, and Sacramento County.
DISCUSSION:
Due to the increased cost of living and higher expenses, a rate adjustment has become necessary, which has resulted in the need to increase the maximum obligation.
Behavioral Health and Recovery Services (BHRS) manages the placements in these and other residential services facilities within its total budgeted amount for mental health residential services.
In-county licensed residential facilities serve a critical role in the care of BHRS clients, but there are limited beds available locally. In recent years, the County-licensed residential care market has been struggling. Established licensed residential care contractors in the County have been retiring and shuttering their operations, and new facilities are not being opened to succeed them. BHRS has attempted to engage with new in-county mental health residential center operators, but these operators are not interested in serving clients with severe mental illness or for relatively low expected revenue. As a result of these accumulated factors, over the past few years, BHRS has lost six in-county contracted licensed residential care facilities, resulting in a total loss of 41 beds.
Due to this in-County residential facility shortage, BHRS must contract out-of-county licensed residential facilities. These out-of-county facilities provide long-term placements and care for a population of clients that are often stigmatized and perceived as having too many complex issues. These facilities provide clients with meals, assistance with daily living activities, medication support, and social skills development. All BHRS clients placed in a contracted out-of-county licensed residential facility are closely followed by the BHRS Collaborative Care Team.
The needs of clients served by these facilities, as well as the uniqueness of the local licensed residential care market, inform the procurement approach that the County has adopted for these contracts. Additionally, the Administrative Memorandum B-1 includes an exception to the competitive procurement process for Housing Services and Related Supports.
The resolution contains the County’s standard provisions allowing amendment of the County’s fiscal obligations by a maximum of $25,000 (in aggregate).
The amendment and resolution have been reviewed and approved by the County Attorney as to form.
It is anticipated that no more than 15% of all admissions will be discharged to an acute psychiatric level of care.
PERFORMANCE MEASURE:
|
Measure |
FY 2024-25 Actual |
FY 2025-26 Estimated |
|
Percentage of clients discharged to an acute psychiatric level of care |
15%
3 of 18 clients |
≤15%
3 of 18 clients |
COMMUNITY IMPACT:
This contract will positively impact a critically underserved community of behavioral health clients who have severe mental illness and need residential placement. Residential providers such as Psynergy are a vital resource for housing such individuals. This amendment to the agreement with Psynergy will continue to afford these individuals an ability to step down from higher acute, more costly levels of care to a community placement. This provider is committed to serving this population and supporting them with being successful while living in a community setting.
FISCAL IMPACT:
The term of the amended agreement is July 1, 2024, through June 30, 2027. The amount of the amended agreement is not to exceed $5,809,122. The amendment increases the contract amount by $279,000. Funds in the amount of $279,000 are included in the BHRS FY 2025-26 Recommended Budget. Of that amount, 1991 Realignment will fund $279,000. There is no Net County Cost.